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Category: Volume 08 Issue 02 February 2020
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Title: Role of C-Reactive Protein levels in Differentiating Upper Urinary Tract Infection and Lower Urinary Tract Infection in Adults

Authors: Gorijavolu Mamatha, M V V Gandhi, Malla Phanindra

 DOI: https://dx.doi.org/10.18535/jmscr/v8i2.49

Abstract

Background: Urinary Tract Infection (UTI) is common infection in everyday practice. Mortality and morbidity is increased in UTI complicated with bacteremia.UTI above bladder is considered as upper UTI and below as lower UTI. Distinction between upper UTI and lower UTI is more important because it has a therapeutic and prognostic significance. Elevated CRP levels are often seen in acute pylonephritis and rarely in cystitis.

Methods: Present study was a cross sectional study in King George Hospital from October 2017 to May 2018 in patients having culture positive UTI. Patients were categorised into upper and lower UTI based on clinical features. Patients having suprapubic pain, dysuria, frequency, urgency are considered as having lower urinary tract infection. Patients having loin pain , renal angle tenderness, temperature equal or more than 38.5 c, and features of sepsis are considered as having upper urinary tract infection.

Results: Out of 65 cases 43 were females and 22 were males, 26 were upper UTI and 39 were lower UTI. On urine culture E.coli was grown in 64.6% klebsiella in 13.8% Proteus in 6.15%, staph. aureus and steptococcus in 2 cases each, pseudomonas in one case and others 6.15%. Mean value of CRP upper UTI is 126.6mg/L and lower UTI is 5.1 mg/L which is statistically significant (p<0.01).

Conclusions: C-reactive protein is a good diagnostic tool in differentiating upper UTI and lower UTI as it is significantly raised in upper UTI and it is a non invasive diagnostic tool. Longer follow of CRP up may point to high risk cases which are likely to develop chronic parenchymal renal disease.

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Corresponding Author

Gorijavolu Mamatha

Junior Residents, Department of General Medicine, Andhra Medical College